Makerere University School of Public Health, Kampala, Uganda.
AIDS Behav. 2011 May;15(4):751-60. doi: 10.1007/s10461-010-9704-1.
Linkage to HIV care and survival in sub-Saharan Africa is not well documented. In 2004 we conducted a randomized trial among medical inpatients in Mulago Hospital to assess the impact of HIV counseling and testing (HCT) on linkage to care and survival. Participants were randomized to inpatient HCT (intervention) or outpatient HCT 1 week post-discharge (control); inpatient HCT was not available at Mulago during the study. Among 590 eligible patients, 85% (500) agreed to participate; 98.8% (248) in the intervention arm received HCT compared to 68.7% (171) in the control arm. Within 6 months, 62.2% (92) of surviving HIV-infected participants received HIV care; 15.0% (20) received antiretroviral medications (ARVs). Overall mortality among HIV-infected participants was 34.6% (72). HCT had significant impact on linkage to care among surviving participants. Referral for HCT was a missed opportunity for diagnosis. There is need for earlier diagnosis and linkage to HIV care among inpatients.
在撒哈拉以南非洲地区，将艾滋病毒护理和生存情况联系起来的工作记录并不完善。2004 年，我们在穆拉戈医院对住院患者进行了一项随机试验，以评估艾滋病毒咨询和检测（HCT）对护理和生存情况联系的影响。参与者被随机分配到住院 HCT（干预组）或出院后一周的门诊 HCT（对照组）；在研究期间，穆拉戈医院没有提供住院 HCT。在 590 名符合条件的患者中，85%（500 名）同意参加；干预组的 98.8%（248 名）接受了 HCT，而对照组的 68.7%（171 名）接受了 HCT。在 6 个月内，62.2%（92 名）幸存的艾滋病毒感染者接受了艾滋病毒护理；15.0%（20 名）接受了抗逆转录病毒药物（ARVs）。感染艾滋病毒的参与者的总死亡率为 34.6%（72 名）。HCT 对幸存参与者的护理联系产生了重大影响。转介进行 HCT 是诊断的一个错失的机会。需要在住院期间更早地进行诊断并与艾滋病毒护理联系起来。
